Provider Demographics
NPI:1205069424
Name:LIFEGUIDES, LLC
Entity type:Organization
Organization Name:LIFEGUIDES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:ORLOUSKY
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, LCDC-III
Authorized Official - Phone:614-342-0243
Mailing Address - Street 1:930 THAYER DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43230-6241
Mailing Address - Country:US
Mailing Address - Phone:614-342-0243
Mailing Address - Fax:
Practice Address - Street 1:930 THAYER DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43230-6241
Practice Address - Country:US
Practice Address - Phone:614-342-0243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-04
Last Update Date:2009-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH091032101YA0400X
OHE-0500159101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty